A host of new discoveries bring medicine closer to the goal of ending heart attacks. These include new protective methods that can help identify those at risk. Although current cardiovascular testing allows doctors to guess at a patient’s risk level, new approaches are identifying a person’s likelihood of suffering a cardiac incident both earlier and with greater accuracy. There are also new treatments on the horizon which have proven capable of slashing heart attack risk. These include drugs that mimic natural processes in the body to reduce bad cholesterol in the blood.
Half a century ago, a person living in the UK was four times as likely to die of a heart attack than they are today. This changed when, in 1976, Michael Davies discovered that heart attacks were caused by blood clots. This discovery opened the door for a wave of new drugs and lifesaving procedures. Although these medical discoveries significantly reduce the risk of dying from a cardiac event, heart disease remains one of Western society’s biggest killers today.
If you go to your doctor's office today, professionals will assess your cardiovascular risk by weighing factors like age, family history, cholesterol levels, blood pressure readings and factors from your social history like smoking and drinking habits. Newer therapies use your genetic data, artificial intelligence, and even injectables in their quest to save lives. The focus of scientists is to accurately predict cardiovascular risk and act early to prevent damage to the heart and vasculature.
Researchers have long hoped to identify a biomarker that would predict the fragility of artery lining plaques. These plaques are what break off and block blood flow to the heart, resulting in heart attacks. Currently, to observe the state of these plaques, imaging called a coronary angiography is used. This test allows doctors to see which arteries are blocked, and by how much. What these tests don’t show is the likelihood that a portion of that blockage may break off.
In their search for a biomarker that would identify such likelihood, scientists begin testing for the chemicals produced by the body during inflammation. This is done because inflammation in the arteries is a good indication that a plaque lesion may break off. A ten-year evaluation of this technique, published in The Lancet in 2018, showed that measuring for these chemicals provided a good test of heart attack risk.
In a study published in the Journal of the American College of Cardiology (JACC), researchers sought to develop a genomic risk screening system for heart attack prevention. What researchers found was, that based on genetic variants and health history, an algorithm could be developed to accurately predict heart risk, using a patient’s genetic profile.
Another advancement in detecting heart attack risk improves upon MRI scans. Researchers have done this by injecting molecular probes into the blood. These probes seek target molecules to latch onto. This allows scientists to observe the chemical processes within the arteries during MRI scans.
Other similar techniques have illuminated cardiac biomarkers in animal models. This allows doctors to see LDL cholesterol on a CAT scan. Someday this may help doctors deliver drugs directly to targets within the body.
Though these advancements aid prediction, there must also be a push for improved treatment.
Current drug treatments, called statins, are effective at lowering cholesterol. These drugs substantially reduce the risk of heart attack and stroke. But researchers have found new evidence that targeting inflammation in the arteries may be an excellent way to improve outcomes for cardiovascular patients.
A new drug, called Canakinumab, does just that and was found to reduce the risk of heart attack by 24%. This and other new drugs are created from artificial antibodies, and their success indicates they may soon overtake statins.
The antibodies mimicked by these new drugs occur in the body naturally. Some people have more of them than others, and a high count of these antibodies in the blood seem to indicate lower levels of risk. Some specialists, like Dr. Ramzi Khamis from the Imperial College in London, are looking to those naturally occurring antibodies for future treatments. “That may be ten years ahead, but there is that potential,” says Khamis indicating a bright future for cardiovascular medicine.
Sources: The Journal of the American College of Cardiology, Science Focus
